The Dying Patient in Psychotherapy: Desire, Dreams and Individuation by Joy Schaverien ( Palgrave Macmillan, October 2002).

Death is a taboo subject and we shy away from it despite the fact that it is continually present in our lives whether it is the death of a loved one, a close friend, or someone who is unknown to us. Death is something we don't want to think about, even though it is inevitable; it is the one experience in life, apart from being born, that we can be sure will happen to us. As practitioners of psychotherapy we need to be prepared for either a client or the therapist developing a terminal illness during the course of the work.

, in his book The Gift of Therapy, says that although fear of death is something that haunts us throughout life, against which we erect defences to help us cope, we cannot keep it out of our mind. If this is the case, why, he asks, do most therapists avoid direct discussion of death? Is it because they don't know what to do with death, or because it might inspire great anxiety in an already anxious client and perhaps also in the therapist, or because they follow the maxim if it doesn't itch don't scratch it? Yet, as he says, ‘Given the centrality of death in our existence, given that life and death are interdependent, how can we possibly ignore it?’ (p. 124).

Perhaps it is telling that the subject of death is not something that has been prevalent in my own therapy or my clinical work and that there was very little reference to it on my training course. Yet it is more than likely, with the increasing acceptance of psychotherapy, that at some time during our careers as therapists working in private practice we will be confronted with someone suffering from a life-threatening illness; something that neither client or therapist were aware of when they embarked on the work. It may be that the fact that the subject is not addressed unconsciously conveys the difficulty in looking at a situation we would, in all probability, want to avoid. It is perhaps a subject that is of little